title: Evaluation of lipid layer thickness measurement of the tear film as a diagnostic tool for Meibomian gland dysfunction.
abstract: OBJECTIVE
  The LipiView interferometer (TearScience Inc, Morrisville, NC) is capable of delivering quantitative values of the tear-film lipid layer thickness (LLT). The purpose of this study was to investigate whether there is a correlation between the LLT and other diagnostic criteria for Meibomian gland dysfunction (MGD).
  
  
  METHODS
  We performed a retrospective analysis of 110 patients (199 eyes) from our dry eye clinic. Subjective symptoms, break-up time (BUT), expressible Meibomian glands, and LLT were measured.
  
  
  RESULTS
  There was a significant correlation between expressible Meibomian glands and LLT (r = 0.36, P < 0.0001). Also, a possible trend of inverse correlation between subjective symptoms (standard patient evaluation of eye dryness) and the LLT was observed; however, this was not significant (r = -0.13, P < 0.08). Analysis of the whole study collective revealed no correlation between the BUT and the LLT (r = 0.003, P = 0.97). A subgroup analysis of the patients with an LLT ≤ 60 showed a better correlation between the LLT and the BUT, which was marginally not significant (r = 0.21; P = 0.059). For a cut-off value of ≤ 75-nm LLT, we found a sensitivity of 65.8% and a specificity of 63.4% for the detection of an MGD. For a cut-off value of ≤ 60, the sensitivity was 47.9%, and the specificity was 90.2%.
  
  
  CONCLUSIONS
  The positive correlation between the LLT and expressible meibomian glands found in this study suggests a higher probability of MGD in patients with a low LLT. This automated assessment of the LLT might be a suitable screening test for detecting MGD. However, further prospective studies are needed to confirm these results and to identify potential confounders.
authors.affiliation: Department of Ophthalmology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Finis
authors.forename: Nadja
authors.initials: N
authors.lastname: Pischel
authors.forename: Stefan
authors.initials: S
authors.lastname: Schrader
authors.forename: Gerd
authors.initials: G
authors.lastname: Geerling
mesh_terms: D000328:Adult; D000368:Aged; D003941:Diagnostic Techniques, Ophthalmological; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008537:Meibomian Glands / Q000378:metabolism*; D008563:Membrane Lipids / Q000032:analysis*; D008875:Middle Aged; D012189:Retrospective Studies; D013666:Tears / Q000737:chemistry*; D055815:Young Adult
chemical_list: D008563:Membrane Lipids